For over two decades, society has been fighting a losing battle against the “epidemic of bullying.” Because we have come to rely on researchers for the solution, but researchers routinely recommend programs despite their poor results, I wrote a piece eight years ago called, “The First Step to Ending the Bullying Crisis.” It maintains that we will never turn the tide in this campaign until researchers begin questioning the bullying orthodoxy.
To my great excitement, a scholarly paper has been published that does exactly that. “Hypotheses for Possible Iatrogenic Impacts of School Bullying Prevention Programs,” by Karyn L. Healy, Ph.D., of the QIMR Berghofer Medical Research Institute, Australia, takes the bold step of highlighting findings that not only don’t most of the prevalent anti-bullying interventions work well, they may even be iatrogenic, creating problems for victims.
The concept of iatrogenic illness has been recognised at least since the time of Hippocrates. Iatrogenic means that the illness is caused or exacerbated by the physician or medical facility that is responsible for curing the patient. Many things can go wrong. We can contract bacteria and viruses from other patients in the hospital. Doctors and other professionals can make unwitting mistakes. Medicines can have unexpected interactions and side effects.
In contrast, when it comes to anti-bullying interventions, few researchers have considered the possibility that they can be iatrogenic.
I am not a researcher, but a practitioner. I studied psychology because of a passion to learn to help people solve their problems.
For over 20 years, I have been arguing that the orthodox field of bullying psychology (or anti-bullyism, as I prefer to call it) is iatrogenic, though I had never used that term before. Anti-bullyism stems from the work of Prof. Dan Olweus, the acknowledged founder of the scientific bullying field. When I examined it, I concluded that it couldn’t work because it prescribes interventions that are contraindicated by well-established principles of psychology and psychotherapy.
Treating hypotheses as axioms
The precepts fostered by antibullyism — that victims have nothing to do with being bullied, that the solution must involve the entire community, that bystanders are key to stopping bullying, that children must inform the school authorities when they are bullied — are in reality hypotheses requiring validation.
However, they are typically treated as axioms — fundamental truths that are upheld regardless of the evidence against them. Researchers of anti-bullying programs usually conclude that they are efficacious despite their own findings to the contrary.
The most recent example is a meta-analysis of the effectiveness of anti-bullying programs, published in the prestigious Journal of the American Medical Association. Here is the conclusion of the researchers:
Despite the small ESs [effect sizes] and some regional differences in effectiveness, the population impact of school anti-bullying interventions appeared to be substantial.
Small effect sizes are substantial? Really?
Revealing inconvenient findings
In her current paper, Healy targets in particular the widely acclaimed strategy of encouraging bystander intervention for victims against bullies. While I have written a couple of detailed articles on the problems with bystander intervention, it is refreshing to find a researcher doing so.
Healy suggests explanations for the potential counterproductive effect of this mainstay of the anti-bullying arsenal, based on an understanding of interpersonal dynamics rather than on the wishful thinking of the orthodoxy that bullying will disappear if everyone refuses to tolerate it.
Healy reports on research findings that:
Despite concerted international efforts, bullying prevention programs have resulted in only small overall reductions in bullying … and victimization … with diverse outcomes among studies, programs, and individuals … Overall, programs have a small positive benefit for primary school students … but no benefit for secondary school students.
She goes even further with a rare assertion:
Furthermore, even when an intervention successfully reduces overall bullying, it may still lead to less optimal outcomes for students who are victimized after the program’s implementation.
Indeed, interventions can cause harm to those who most desperately need help. Unfortunately, research studies often neglect to consider the possibility that anti-bullying programs might have unintended negative effects.
The mistake of researchers
To measure the effectiveness of school anti-bullying interventions, there a couple of variables that researchers generally measure. One is the reduction in overall aggression. A second is the reduction in the percentage of children who are victimized at least twice or more per month.
But the reason for the existence of anti-bullying interventions is not just a reduction in overall aggression or in the number of children who are victimized once in a while. Their purpose is to relieve the suffering of the true victims of bullying — the kids who are picked on every single day, especially those who have become ostracized by their peers. Those are the children who are anxious and depressed, have trouble concentrating in school, and may contemplate violence against themselves or others.
The suicides of bullied children provided an impetus for the development of bullying psychology a few decades ago, and the school shootings committed by victims of bullying in the late 1990s launched the worldwide war against bullying. Strangely, researchers seldom if ever focus on these most impacted victims. And as Healy suggests, it is possible for an intervention to reduce aggressive acts in general while actually aggravating hostilities towards the small minority of students who suffer terribly.
In discussing the lackluster results of bystander intervention programs, Healy reports that the highly regarded KiVa program from Finland claims significant reductions in bullying. However, she astutely notes that KiVa is likely to exacerbate the situation of individual victims:
Students reporting ongoing or new victimization at a 1-year follow-up assessment had higher depression in schools that used the KiVa program than in control schools (Huitsing et al., 2018).
Unlike many research papers I have seen that make excuses for the poor results of anti-bullying interventions, Healy takes them at face value and offers reasonable hypotheses to account for them.
While Healy goes into much greater detail in her paper, with the use of flowcharts to illustrate the dynamics, the following are my summaries of her three hypotheses. (In bold are Healy’s own formulations of the hypotheses.)
1. Peer defense may disempower victims. Kids who stand up for victims against bullies may feel proud of themselves, but they may also give victims the message that they are incapable of handling the problem on their own. Victims could learn to feel helpless, which may increase their depression while attracting more bullying. They may expect bystanders to save them in the future, rather than take responsibility for solving their own problems.
2. Peer defense of victims may reinforce as well as provoke bullying. The bullies’ power and status may be enhanced when additional people stand up against them, encouraging them to repeat the bullying. Furthermore, the bystanders might humiliate and antagonise the bullies, causing them to retaliate against the victims, who again need to be protected by the bystanders.
3. Peer defense might erode broader peer support for the victim. When kids stand up for victims, they may bring attention to the victims’ inferior social status and thereby add to their stigmatization and feelings of inadequacy. This could be especially detrimental when the bystanders intervene in subtle bullying, which may have gone relatively unnoticed by others, but now becomes a focus of wider attention. Victims’ social attractiveness is lowered and they end up with fewer friends.
Healy’s boldest stance
It takes courage to challenge a belief widely held by one’s professional peers. Healy’s boldest move, though, may not be the exposure of the problems with bystander intervention, but something more fundamental.
As Healy says,
Intervention research has largely overlooked the role of victims in influencing bullying dynamics. This may reflect early literature that equated examining the role of victims with blaming the victim.
The fear of “blaming the victim” is not just a feature of “early literature” but is as strong today as ever. Researchers seem to refrain from studying programs that put any responsibility on victims — which may prove to be the most effective approach.
My hypothesis regarding Healy
What has led Karyn Healy to challenge the bullying orthodoxy?
It may be because in addition to being a researcher, she is also a therapist. Therapists know that the person we lead to change is the one who comes asking for help. And that is the victim, not the alleged bully. Telling people, “So-and-so says you are bully and therefore I need to help you change” is not likely to be met with, “Thank God someone finally complained about me. I could really use some therapy.”
Unfortunately, bullying researchers do not always display awareness of the therapeutic process. Healy does. She is a family therapist, so she understands interpersonal dynamics, and that is strongly reflected in her article.
In fact, she has already conducted research on a bullying prevention program that focuses solely on helping victims acquire the skills for dealing with bullying. It was published six years ago: “Randomized Controlled Trial of a Family Intervention for Children Bullied by Peers.” The results were better than anything I have seen from the popular anti-bullying programs.